HF0906-七年制.pptVIP

专家称全国心力衰竭患者超过1100万发布时间：2009年05月20日 03时27分　　　来源：中国新闻网　　 ???  中国内地每十五秒就有一人被心脑血管疾病夺去生命，每二十二秒就有一人因此致残而丧失工作能力。 目前全国约有超过一千一百万心力衰竭患者，而随着人口老龄化和生活方式的改变，其患病率还将会持续增加。 从上世纪五十年代至今，中国心脑血管病增加了四倍，已占总死亡率的百分之三十六。 目前中国每年用于心血管疾病的治疗费用已达三千亿元人民币。 Basic Concepts Causes Classification of heart failure Compensatory mechanisms in heart failure Pathogenesis of heart failure Functional and metabolic alterations Treatment principles Ⅰ. Basic Concepts Cardiac insufficiency Heart failure Congestive heart failure Myocardial failure ? Cardiac insufficiency: causes → pump function↓ Heart failure is the pathological process in which the systolic or/and diastolic function of the heart is impaired, and as a result, cardiac output decreases and is unable to meet the metabolic demands of the body. Congestive heart failure is a kind of chronic HF with expansion of blood volume. Myocardial failure is one kind of heart failure, which is caused by the impaired myocardium itself. 1. Etiological causes (1) Dysfunction of myocardium 1) primary myocardial damage: Myocardial infarction; Myocarditis; Cardiomyopathy; toxic 2) Secondary myocardial damage (metabolic disturbance) Coronary heart disease; Severe anemia; Diabetic mellitus; VitB1 deficiency (beriberi) (2) Overload for myocardium 1) Pressure overload (increased afterload): (Afterload is the resistance to shortening that the muscle must overcome during contraction.) aortic narrow 2) Volume overload (increased preload): Preload is the stretch exerted on the muscle in the resting state. (diastolic phase.)  Reasons of increased volume overload for left ventricle: (a) aortic regurgitation (b) mitral regurgitation Reasons of the volume overload for right ventricle: (a) pulmonary regurgitation (b) tricuspid regurgitation (c) Interventricular septal defect (d) interatrial septal defect (e) Increase